~Objectives: Define co-occurring disorders Identify the impact of addiction on the individual Identify the impact of mood disorders on the individual Identify the impact of chronic illness or pain on the individual Explore the interplay between the three Why I Care/How It Impacts Recovery Co-Occurring Disorders are the EXPECTATION, not the EXCEPTION. A person who is sober but depressed is at risk for addiction relapse A person who is using is actively in an addiction (even a behavioral one) is altering the balance of neurotransmitters. ~Define Co-Occurring Disorders Mental Health, Addiction, Physical Health problems and their interaction Must be treated concurrently ~Think About It When you are stressed out how does it impact your Mood Patience Ability to concentrate/productivity Problem solving/creativity Sleep Energy levels Appetite Headaches Muscle Aches ~Think About It People with addictions are: Trying to get some relief from emotional or physical distress Inadvertently worsening the problem by altering the neurochemicals ~Mental Illness Effects Emotionally Depression or anxiety Cognitively Difficulty concentrating Perception of hopelessness and helplessness (Victim mentality) Physically Sleep disturbances Eating Disturbances Restlessness/agitation Achiness Fatigue ~Mental Illness Impact Socially Withdrawal/Difficulty dealing with people Low self-confidence Lack of energy or desire to interact Relationship deterioration Environmentally (The outside reflects the inside) Disorganization Lack of energy or desire to care for anything ~Mental Illness Addictive Behaviors Emotionally Addiction numbs or medicates depression or anxiety Cognitively Addiction reinforces hopelessness and helplessness (Victim mentality/stinking thinking) Physically Addiction helps people relax to get to sleep OR keeps them up instead of sleeping Food is often used as a secondary self-soothing/addictive behavior OR people get so caught up in their addiction they forget to eat ~Mental Illness Addictive Behaviors Physically Addiction helps soothe restlessness/agitation, but detoxing can intensify it Achiness can be relieved or numbed by addictions, but (especially in the case of opiates) may cause the body to stop making or using endogenous opioids. Addiction to stimulants may be used to self-medicate fatigue, but causes rebound exhaustion. ~Mental Illness Addictive Behaviors Socially Addictions may be used to “loosen up” or make it easier to interact with others The addiction may provide an alternate peer group that is tolerant Environmentally (The outside reflects the inside) In active addiction, there is little concern for the environment UNLESS the person is trying to hide the addiction in which case, they may become more attentive to cleanliness and organization. ~Addiction Effect (Benefits?) Emotionally Numbing Relaxation Euphoria Cognitively Stinking thinking Physically Energy Improved Sleep Relaxation Socially A new peer group Environmentally ~Addiction Mental Illness Emotionally Addiction causes neurotransmitter imbalances As depression and anxiety worsen, the need for the addiction/numbing increases. Life starts to revolve around using The brief benefits lead to a continued need for the addiction to feel “normal” Mentally/Cognitively Addiction leads to lying, manipulation, and exacerbates cognitive distortions (stinking thinking) Physically Addiction usually disrupts circadian rhythms through too much or too little sleep Addiction can alter hunger/satiation cues Addiction can cause health problems leading to chronic pain Socially Addiction becomes the person’s best friend Begin spending time only with using peers or alone Loss of healthy relationships They don’t get it They want to take away the addiction Environmentally (Inside | Outside) Addiction takes precedence over environmental cleanliness or safety feelings of depression Addiction can cause a person to become obsessively neat to hide the fact that they are addicted ~Chronic Pain Emotionally Frustration Depression Anxiety Cognitively Difficulty concentrating Negative perceptions Physically Sleep disturbances Fatigue Pain Socially Don’t feel like going out to do things with friends Friends get tired of hearing about the pain Friends may feel taken advantage of Environmentally Disarray May stay in bed or on the sofa all the time ~ Chronic Pain Addiction & Mental Illness Emotionally Opiate medications often intensify depression Negative feelings can be numbed with addiction Cognitively Chronic pain creates a an environment for the victim mentality/stinking thinking common in addiction and mental illness Physically Sleep disturbances and fatigue leading to irritability, depression and self medication Pain medications can actually intensify pain. Socially Addiction helps people not care that they don’t have healthy relationships Environmentally A depressing environment may intensify feelings of hopelessness which can be self-medicated with addiction An obsessive need for order, but being in too much pain to clean can intensify anxiety which can be numbed with addiction ~Addiction, mental health and physical illnesses all impact Mood Eating Sleeping Pain Motivation Relationships Addiction may temporarily address the issue, but it also intensifies all of the above problems when the person is not actively using. Summary ~ Summary Comprehensive treatment of the whole person is vital Example: Lack of pleasure Address the neurochemical imbalances Find alternative coping strategies besides the addiction Identify cognitive issues that may be maintaining the negative mood Identify any physical issues (chronic pain, hormone imbalances) that are contributing Effects Improved motivation Improved ability to focus Improved mood

AllCEUs started providing affordable CEUs and counseling continuing education, including online ceus and webinar based counseling ceus, in 2006 to help counselors licensed by their state board of professional counseling or state board of alcohol and drug abuse access affordable counselor continuing education, meet their continuing education requirements and enhance their addiction or mental health counseling practice. Since then, other companies have joined the marketplace to provide lpc continuing education including quantumunitsed, ce4less, Aspira aspirace, tzkseminars, i-counseling, accessceu, CEUbynet, pdresources. AllCEUs pioneered the model of offering unlimited CEU packages for a flat rate. We also were the first to offer live webinars each week for $5 per counseling webinar. We pride ourselves on having the largest catalog, with well over 200 multimedia, online counseling CEU courses. AllCEUs is an approved continuing education provider by the Connecticut Certification Board, The Florida Certification Board, FCB, The Alcohol and Drug Abuse Counseling Board of Georgia, ADACB-GA, NAADAC, the association for addiction professionals, the Texas Board of Social Work, The Texas Board of Professional Counseling, The Texas Board of Marriage and Family Therapy, California Consortium of Addiction Programs and Professionals, the Florida Board of Social Work, Mental Health Counseling and Marriage and Family Therapy and many other boards. It is important to note that, in most states, CEUs are NOT required to be NBCC approved, and most states accept ceus which are NOT from an NBCC approved continuing education provider or ACEP. For specific information about which other approval bodies your state accepts, you can visit our approvals page: https://cdn1.allceus.com/wp-content/uploads/2017/01/NewStateApprovalChart2017-1.pdf which provides a summary and links to the documents of the various state licensing boards for counselors, therapists and social workers. For mental health counselors, social workers and marriage and family therapists in Florida, AllCEUs reports your counseling CEUs to CE Broker. Whether you are a LCSW, MSW, LMFT, LMFT LMHC, LPC, LPCC, LCPC, CCMHC, MHC, CADC, LADC, CAP, LCDC, recovery coach, psychotherapist, pastoral counselor, addiction counselor, substance abuse counselor, recovery specialist, behavioral health technician needing mental health or addiction counseling CEUs online, or wanting to get certified as an addiction professional, AllCEUs has a variety of affordable online counseling CEUs, online addiction counselor certificate training tracks and face to face training options. Our unlimited CE packages provide professional counselor continuing education (CEUs) in addiction counseling, transdisciplinary foundations of addiction counseling, screening and assessment, diagnosis, family therapy, pharmacology, psychopharmacology, case management, crisis intervention, counseling tools, dialectical behavior therapy, mindfulness, acceptance and commitment therapy, ethics, supervision, working with adolescents, and many more.